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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada


Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091



BC: Articoli scritti da J. Turkman

Riscontro occasionale di una condizione emolitica mediante la determinazione di HbA1c in elettroforesi capillare
Casual finding of a hemolytic condition through the determination of HbA1c by capillary electrophoresis.
<p>HbA1c is a major hemoglobin characterized by nonenzymatic binding of glucose to the N-terminal valine residue of the hemoglobin &beta;-chain, which reflects average glucose levels during the erythrocyte lifespan. This test has been recommended for diabetes monitoring and even for diagnosis, as well as in assessing the risk for chronic complications in diabetic patients. Therefore, an accurate measurement of HbA1c is extremely important. However, the reliability of HbA1c is impaired in certain clinical conditions, such as hemolytic anemia, blood transfusion, renal disease, and pregnancy, that increase the erythrocyte turnover or reduce its lifespan. We report the case of a 38-years-old woman with previous history of high fasting plasma glucose level who underwent routine laboratory assessment. The analysis of HbA1c by capillary electrophoresis (CE) showed an atypical profile with a clear presence of abnormal hemoglobin that did not allow to obtain a reliable result for HbA1c. The same sample analyzed by HPLC showed, the presence of an abnormal Hb and obtained a different result for HbA1c. Subsequently, the analysis of hemoglobin fractions in CE (using Hemoglobin kit- Sebia) confirmed an atypical profile with the presence of an abnormal hemoglobin peak (27.3%) in the &ldquo;zone Z15&rdquo; and low HbA2 (0.5%). The molecular investigation of the globin genes highlighted the presence of three mutations of the &alpha;-genes compatible with HbH disease. The HbH disease is responsible for a hemolytic condition that is associated with reduced erythrocyte survival, making it impossible to use HbA1c for diagnosis and monitoring the glycemic status in this patient. The use of separative technologies, such as CE and HPLC, has been useful to detect a thalassemic defect, which must be reported to allow correct diagnostic conclusions. In this condition, the introduction of alternative biomarkers like glycated albumin (GA) is thought to be more reliable than HbA1c, since GA values are not influenced by the modifications of the erythrocyte lifespan.</p>
Biochimica Clinica ; 46(3) e11-e14
Casi Clinici - Case Report
 
La sfida del riconoscimento del professionista in Medicina di Laboratorio in Europa: gli strumenti a disposizione per aumentarne la visibilità e la qualità
The challenge of recognising Laboratory Medicine professionals in Europe: available tools to increase their expertise and visibility
P. Zaupa  |  J. Turkman  |  M. Zaninotto  |  D. Basso  | 
<p>&nbsp;</p><p>&nbsp;<span style="font-size:9.0pt">Laboratory Medicine is essential in all steps of patient care and to maintain and improve its value, promoting its recognition and visibility is vital, but such endeavor is hampered by a lack of harmonization across the European Union (EU). Specialists have different names, pre-graduate education, legal status and specialist training. Thanks to the European Directive 2013/55/EU, automatic recognition of a profession is possible if one third of EU nations agree on the adoption of a &ldquo;Common Training Framework&rsquo;&rsquo; (CTF), which defines the common set of knowledge, skills and competences needed to pursue a profession. The EFLM Syllabus was used as a base upon which to build the CTF regarding specialist training, along with EFLM&rsquo;s Equivalence of Standards (EoS) for pre- and post-specialty requirements. Professionals who trained following the Syllabus and meet EFLM&rsquo;s EoS can be added to the EFLM&rsquo;s European Register of Specialists in Laboratory Medicine. Standardization of specialist training is required to improve the quality of our profession and will allow specialists to work in different countries more easily. This is further facilitated by the EFLMLabX platform. The adoption of the CTF, the continuous harmonization process, the EFLM&rsquo;s Register and its available tools to improve specialists&rsquo; skills and competences will increase the visibility of our profession, facilitating its recognition process by the European Parliament. This undertaking is not only needed for the recognition of our profession, but to also improve its quality across all European countries, which will positively reflect on patient care.</span></p>
Biochimica Clinica ; 17(1)
Documenti - Documents